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Community & Behavioral Health | Recovery | Social Change


Changing the Conversation

Healthcare Disparities: Is Racism in Play?

05/3/16 11:04 AM | Gloria Dickerson | Health Care, Race


We know that healthcare disparities exist! Statistics can tell us where disparities are occurring, which providers have the worst outcomes, and what medical decisions are contributing to the problem.

Resolving healthcare disparities is hampered when we refuse to ask hard questions about conscious and unconscious bias among service providers and staff. For example, research on obesity has documented that physician attitudes greatly impact service use, quality, and outcomes. Studies on the impact of physician attitudes demonstrate that examining bias is critical for understanding how patients use services and how well they do.

Additional research is necessary to investigate how physician bias and attitudes contribute to disparate outcomes for People of Color. Examining bias stemming from the racial attitudes of physicians will help decipher contributing factors that lead to disparate outcomes. It is not a stretch to ask if attitudes bias treatment decisions and lead to poor outcomes. For example, is racism in play in medical decision-making and is it contributing to healthcare disparities? Learn more about how communication shapes medical treatment and outcomes.

To date, inquiries into contributing factors to healthcare disparities remain incomplete and have failed to fully address this issue. The National Healthcare Quality and Disparities Reports attribute the causes to lack of service use by patients and fragmented healthcare structures. This research implicitly blames the victim and diverts attention from a critical issue: What is the role of racism in medical decision-making and service provision for African Americans and other People of Color?

Bias is hard to prove! Knowing where pools of disparities are occurring would be helpful for developing effective solutions. We can find the answers with statistical data if we generate the right questions. Are there specific groups of providers whose patients have greater differences in outcomes? Are there routine practices, ways of arriving at medical decisions, and prioritizing interventions that lead to disparities?

It may be that there are “normal” processes and specific decision-making practices that result in the most disparate outcomes. Are the contributing factors to health care disparities a result of training, physician and staff culture, or gaps in knowledge and experience?

Because statistical data do not rely on opinions and personal communications, fears of being on the wrong end of the blame game would be eliminated. Medical decisions about who gets care and what type may be illuminating and guide systems of care to improving practices that would reduce healthcare disparities.

I applaud providers and staff who question their bias and resist impulses to make automatic negative judgments. There are others who routinely and thoughtlessly place less value on the lives of People of Color. Finding answers depends on the will of policymakers, health administrators, community members, and all of us.

We know that unconscious racial bias as well as overt racism can lead to patient suffering and even death. Failure to research the impact of race in care settings only maintains the impenetrable cloak of silence that protects and invalidates reasonable inquiry. Fair and equal treatment in health care settings must become a reality for all people seeking medical care.

Healthcare disparities speak loudly to all who will listen. Let us keep the conversations on eliminating healthcare disparities alive! As humans, we have great capacity to solve problems once our will is activated. As caring and responsible adults who are interested in achieving quality health care services for all, it is our duty to ask questions about attitudes of providers, including “Is racism in play?”

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Additional Reading

Image by Tom Hart (CC BY-SA 2.0).

Gloria Dickerson

Written by Gloria Dickerson

Gloria Dickerson is a Recovery Specialist at the Center for Social Innovation. Her expertise in recovery derives from academic training and lived experience of recovery from trauma, mental illness, and homelessness. Gloria received a B.S. from Tufts University and has completed master’s level studies in Instructional Design and Psychiatric Rehabilitation.